An internal document from Women's and Children's Hospital states that hospital capacity — for staffing, beds and supplies — is strained, despite assurances from MU Health Care senior leadership last week.
The memo provided to the Missourian, sent Tuesday and written by Director of Nursing and Patient Care Operations at Women’s and Children’s Hospital Christina Hoff-Vollrath, says the hospital does not have all necessary resources at its disposal. The hospitals are seeking solutions by reallocating staff and opening up beds in new locations.
Stevan Whitt, chief clinical officer for MU Health Care and an infectious disease specialist, told the Missourian last Friday “There’s nobody not getting care right now, and there’s no immediate danger (of that happening).”
But the memo describes MU Health Care as "in a crisis." It lays out a plan to repurpose an East Inpatient Expansion Unit, or Medical Care Unit, and move 15 patients from University Hospital. The memo asks nurses with experience caring for adult patients to apply for transfer and promises a monetary incentive for a 12-week commitment.
"Each unit across MUHC (MU Health Care) has been affected by COVID-19 and everyone is working hard," the memo says. "The physicians and nurses caring for the COVID-19 patients in particular are tired and overworked. They've been at this pace for months, mentally and physically exhausted."
The changes come at a time of rising cases and community spread. The number of active cases in Boone County has more than doubled in the past week, and the positivity rate for the county was at an all-time high of 21.3% last week. Surrounding counties also are seeing a rise in cases and positivity rates.
Columbia hospitals are impacted by case growth in more than just Boone County. The surge of hospitalizations from bordering municipalities without mask mandates is hitting some regional hospital systems that serve a wide catchment area. Hospitals are taking more sick people living in neighboring areas that lack adequate medical resources.
MU Health Care doesn't have a single crisis or surge plan, said Jesslyn Chew, public relations manager at MU Health Care. Instead, it has a tiered plan. She said she was uncertain if a new phase or tier of the plan is being initiated right now.
Boone Hospital Center is also working to reallocate resources and solve staffing problems. Robin Blount, vice president and chief medical officer at Boone Hospital Center, said Monday the hospital was increasing the capacity of its COVID-19 unit from 20 to 32 beds. The hospital has also dealt with staffing shortages due to absences related to COVID-19.
The MU Health Care patients who will be transferred to the East Inpatient Expansion Unit are those who would in other times be well enough to transfer to home health care or senior living. However, during the COVID-19 pandemic, those options have become scarce. So the hospital is moving these patients internally to free up intensive care beds to accommodate more COVID-19 patients.
According to the document, since July 1, MU Health Care has deferred more than 700 patients. More than 70% have been due to staffing shortages, and 30% due to not enough beds.
Deferrals, or diversions, refer to when the hospital can't accept a patient from another facility because it doesn't have the specific kind of bed available, or doesn't provide the type of care the patient needs. For instance, MU Health Care does not perform lung or heart transplants; a patient in need of that operation who was referred to them would be deferred, said Chew.
Still, "We don't want people to think that if they're having a stroke or something, we don't have room for them," Chew said. "Because we definitely do."